How Can I Reduce My Risk of Getting Pneumonia?

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Pneumonia is a huge problem, that causes serious disease for patients of all ages. In particular, patients with COPD are at increased risk of having life-threatening pneumonia as a result of having a structural lung disease (like COPD). While there is no guarantee that any one of these measures will keep you from getting pneumonia, these simple behaviors can significantly decrease one’s risk of pneumonia.

  1. Handwashing. First and foremost, incorporating good hand-hygiene behaviors into your everyday life can be, literally, a ‘life-saver’. For viral pneumonias, in particular, simply washing your hands routinely with soap and water can help eliminate the viruses and bacteria that may be hitching a ride. This is particularly important during flu season (the winter months) when exposed to small children or individuals who may be or recently been ill. Antibacterial products and gels are not necessary (soap and water works just fine), but these products do offer a great alternative to running to a sink everytime you are out in public or possibly exposed to germs.
  2. Vaccination. Getting the annual influenza vaccine and the pneumonia vaccine are known to reduce the risk of catching pneumonia and/or getting very ill or dying from pneumonia. For more information on the reasons to get your flu shot, see this article about vaccination for people with COPD.
  1. Ask your doctor about stopping your inhaled steroids. Inhaled steroids are a double-edged sword. They are key aspects of treatment for patients with COPD. Inhaled steroids have been shown to reduce the likelihood of severe COPD exacerbations, and many patients with COPD require them for effective symptom management. The problem with inhaled steroids is that they do increase the risk of severe pneumonia. This is troubling for many clinicians who treat patients with COPD because the very medicine that may help treat the disease, may increase the risk for pneumonias. What’s important to know is that not ALL patients with COPD need to use inhaled steroids, and even if they need steroids at some point, they may not need to use inhaled steroids forever. There are times when patients are placed on inhaled steroids but may eventually get to the point where they are no longer needed. This is a challenging problem that involves weighing the risks and benefits of treatment with inhaled steroids. The best approach is to discuss this with a lung doctor who can help decide if inhaled steroids are truly necessary.
  1. Consider other causes of pneumonia besides “germs”. There are many reasons patients with COPD may get pneumonia. Sometimes it's related to viruses and bacteria, and sometimes it's related to other problems, such as swallowing problems (called aspiration) or immune deficiencies. If you frequently get pneumonias, mention this to your doctor and ask if these other problems may be playing a role, rather than just bad luck. If you are at risk, there are simple tests that can help to determine if these problems are present (swallowing tests, blood antibody tests, etc).

The Bottom Line

  • Patients with COPD are at increased of getting pneumonia and having severe, life-threatening pneumonias.
  • Handwashing and vaccination are the most effective way of reducing the risk of pneumonia.
  • Other factors may play a role (such as use of inhaled or oral steroids, swallowing problems and immunity problems).
  • Stay as safe as possible by discussing these issues with your healthcare provider.

Sources

Suissa S, Coulombe J, Ernst P. Discontinuation of Inhaled Corticosteroids in COPD and the Risk Reduction of Pneumonia. CHEST Journal 2015;148:1177

http://thorax.bmj.com/content/61/3/189.short

http://thorax.bmj.com/content/early/2009/03/24/thx.2008.106286.short

http://thorax.bmj.com/content/68/11/1029.short

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